阮士怡防治射频消融术后心房颤动复发诊疗思路

Professor RUAN Shiyi′s Experience in Prevention and Treatment of Atrial Fibrillation Recurrence After Radiofrequency Ablation

总结阮士怡教授防治射频消融术后心房颤动(房颤)复发的诊疗思路,认为射频消融术前后应分阶段诊治。术前患者以虚为主,心阳气虚为标,脾肾亏虚为本,在调护上注重平衡肾阴、肾阳,同时健运脾气,顾护脾肾令心阳得充,预防术后房颤复发;术后近期以痰瘀互结居多,阻遏心之脉络,导致脉律失调,在治疗上喜用咸寒之品软坚散结调脉律;术后远期则重视从基础疾病、生活方式等多方位调控房颤复发危险因素,在治疗上育心、保脉并举,维护心之本体和正常功用。

This paper summarized professor RUAN Shiyi′s experience in prevention and treatment of atrial fibrillation recurrence after radiofrequency ablation.It is believed that staged diagnosis and treatment methods should be followed before and after radiofrequency ablation.Before the operation,the main manifestation of patients is deficiency syndrome,with heart yang qi deficiency as the branch and spleen-kidney depletion as the root.Therefore,kidney yin and kidney yang should be balanced,and spleen qi should be fortified,thereby preventing postoperative recurrence of atrial fibrillation by supplementing both spleen and kidney and nourishing heart yang.In the short-term period after the operation,binding of phlegm and stasis is most commonly seen,when vessels and collaterals of the heart are constrained leading to disharmony of pulse rhythm;herbs of salty and cold flavors are recommended to soften hardness and dissipate masses,thereby regulating pulse rhythms.In the late postoperative period,regulation of recurrence risk factors from multiple aspects such as controlling basic diseases and life styles is suggested;for treatment,both heart care and healthy pulse maintaining therapies should be applied so that the heart itself and its normal functions can work well.